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County toxicology lab swamped by surge in drug cases, fatal overdoses

It is taking longer for Erie County’s toxicology lab to provide test results because of a surge in drug cases and fatal overdoses, as well as newer designer drugs with hard-to-detect formulations.

That lag time puts more criminal cases at risk, say law enforcement officials.

The lab, which handles more than 600 cases a year, is expected to complete toxicology analyses of autopsy specimens and blood samples within two months. But last year, only 57 percent of the lab’s death-related cases were completed within that time – the poorest turnaround time in years. As of last month, the lab completed only 65 percent of this year’s cases within two months.

Instead, the lab completed most tests within three months.

“By that time, the case may not be prosecutable,” said veteran defense lawyer Joseph Terranova, who handles many drug-related cases.

Police, investigators and lawyers rely on toxicology reports to determine a cause of death, and to help convict drug dealers, rapists and drug-and-alcohol impaired drivers.

Terranova said he’s seen prosecutors with cases stuck in legal limbo even though blood samples have been taken from those accused of driving under the influence of alcohol, or a mix of alcohol and illegal or prescription drugs.

“There’s a blood test, but they can’t get the results,” he said.

So prosecutors present their cases without key evidence. Those cases can wind up dismissed, or reduced to lower charges, penalties or pleas.

That’s primarily true for misdemeanor cases, which must be ready for trial within 90 days and which comprise the bulk of cases handled by the District Attorney’s Office, said First Assistant District Attorney Michael J. Flaherty Jr.

Hiring more staff, including those with experience, would improve the toxicology lab’s ability to identify drugs quickly and accurately enough to help law enforcement, said Dr. Gale Burstein, the Erie County health commissioner. During recent budget hearings, she requested that a quality assurance specialist be hired to help relieve the burden.

Flaherty supports her request for additional staff.

“They’re just overwhelmed right now,” Flaherty said. “They’re all qualified. They’re all competent. But there’s just too much work.”

Law enforcement agencies rely on the toxicology lab to provide key evidence in criminal cases. The lab analyzes dangerous drugs and poisons in the body that may be related to crimes and unnatural deaths.

But many factors interfere with the lab’s performance.

More people are taking more prescription drugs, and opioid overdoses continue to skyrocket. So more cases come into the Medical Examiner’s Office requiring analysis, Burstein said. By the end of this year, drug-related deaths are expected to total twice last year’s number.

The lab is also under pressure to continually develop new tests to analyze designer street drugs, Burstein said. That takes time and training.

While the Medical Examiner’s Office has received more staff in recent years, administrators contend they still fall short compared to other medical examiner’s offices in the region. And the toxicology lab – which falls under the Medical Examiner’s umbrella – has received no additional staff at all.

When Erie County legislators asked during budget hearings why the Health Department needed a new, $51,000 position to oversee quality assurance work at the lab, they received an impassioned response from Burstein.

“The toxicology lab has become very, very complicated,” she told them.

Slow process

The work of the county toxicology lab involves more drudgery and time-consuming analysis than seen on popular crime shows like CSI and NCIS. It requires more manual work than a clinical toxicology lab at a hospital, for instance. Tissue and fluid specimens must go through multiple layers of testing, analysis and confirmation in order to hold up as evidence in criminal court.

The lab performs four different screening methods on specimens with a staff of seven.

Until last year, a single toxicology report took an average of five to six weeks to complete. That’s considered a reasonable, if not ideal, industry time frame.

But lab advocates say that time frame is no longer realistic because of the changing drug landscape.

Nationwide, the number of people taking prescription medication has increased, and Erie County is not immune to the trend. In many cases, drug users don’t take just one or two drugs, but a cocktail assortment of many drugs, experts say. And new types of prescription drugs enter the market all the time.

“When the average number of people who take prescription drugs more than doubles, then you have double the workload,” said Ruth E. Winecker, president of the national Society of Forensic Toxicologists.

The opioid drug epidemic also weighs heavily on the lab. The Health Department has confirmed at least 175 deaths this year through mid-November related to opioid use. Law enforcement officials say the death count would be even higher if it weren’t for the use of rescue drugs like Narcan.

While the office sees more cases overall, a greater percentage of cases involve complex drug testing, said Christine Giffin, the county’s chief toxicologist.

“It is not unusual to find someone taking several antidepressants, antipsychotic and other various medications,” Giffin said. “These drugs must all be individually analyzed and quantitated to get a complete picture of the case.”

Designer drugs

The influx of designer drugs over the past five years presents an even bigger problem.

Chemical tinkering can transform well-known, illegal street drugs or abused prescription drugs into harder-to-detect formulations that may not even be named on an outdated government list of controlled or dangerous drugs. Many produce similar highs and scarier side effects, but they are much more difficult to detect, classify and prosecute.

Entire laboratories are dedicated to tweaking the composition of existing narcotics and illegal drugs to subvert the law, Winecker said.

“The problem with it is, it’s a moving target,” she said. “You just don’t know what you’re looking for.”

A rash of overdoses from a drug that was structurally similar to fentanyl – but was not fentanyl – recently confounded Erie County toxicologists. The drug showed up in many overdose deaths and impaired driving cases. Figuring out how to properly test for this new drug and validate the findings required one analyst’s full-time attention.

“The hardest thing is that you might spend all this time doing this stuff,” Winecker said. “Then you’ll see two or three cases with this type of drug standard, then you might never see it again, because they’re on to something else.”

Synthetic marijuana or “Spice” and lab-created cathinones, typically marketed as “bath salts,” are examples of designer drugs on the market that are wreaking havoc with toxicology labs across the country. Erie County Medical Examiner’s Office administrators say they are working to better detect these drugs but now have “limited or little capacity” to do so.

For that reason, law enforcement officials in Erie County and elsewhere sometimes turn to private labs for substance testing.

Staffing needs

Improving the Erie County toxicology lab’s ability to better identify drugs and do it quickly enough to be of use to law enforcement requires more staff and more experience, according to Burstein, the county’s health commissioner, and Medical Examiner’s Office administrators.

Hence the request for a new quality control specialist in the 2016 proposed county budget. The legislature is scheduled to vote on the budget on Tuesday.

The specialist would work for the Medical Examiner’s Office but assume more than half a dozen administrative responsibilities that are currently falling to the toxicology lab director. Overseeing the validation of new testing methods in the lab would be among the specialist’s responsibilities.

Giffin, the county’s chief toxicologist, pointed to one validation summary she did for a 17-drug panel that generated more than 1,000 pages of paperwork.

The lab also needs experienced people to interpret the test results. County administrators have said these positions pay far less than in the private sector, so attracting experienced personnel is difficult.

Also, Robert Osiewicz, a veteran chief toxicologist, retired last year. While the new chief toxicologist gains experience, the District Attorney’s Office occasionally consults with Osiewicz for his expert opinion. Convictions ride on solid findings and opinions offered to judges and juries.

“We want to make sure all the information, all the data we generate from the Medical Examiner’s Office and the toxicology lab is all quality data and can never be challenged in court,” Burstein said. “You know people’s lives are at stake.”